The Louisville Medical Center (LMC) is a unique venture comprising the University of Louisville Health Sciences Center and Louisville's downtown teaching hospitals: Norton and Kosair Hospitals of Norton Healthcare, Jewish Hospital and Frazier Rehabilitation Center of the Jewish HealthCare and Hospital System, and University of Louisville Hospital. Recognizing that integrated information services are essential to reaching their common goal of providing nationally recognized levels of healthcare service, education and research, these four independent but collaborating entities have begun to build a platform for population-based informatics. LMC plans to focus on informatics infrastructure and processes to achieve an integrated area information management system. The major issue confronting the entities is how to move from what is essentially a Community Health Information Network along a continuum toward an Integrated Delivery Network. Phase I IAIMS funding will facilitate development of long-range information management planning as a core activity within LMC and will bring "top-down" and "bottom-up" planning into fall congruence. The proposed evolutionary informatics model will be one of not only allowing competing and seemingly incompatible technologies, but also encouraging them, with the requirement that each system conform to informatics infrastructure standards. This requirement provides open access to all systems and allows meaningful "competition," particularly at the application level. The proposed method will be one of assessing "fitness" among various component "competitors" rather than specifying an overall, unified scheme or design. An important part of the vision of a dynamic and dependable information utility is a mechanism for continued change and evolutionary growth. For LMC, this will take the form of multi-disciplinary groups, including project "fitness teams." These groups will make recommendations regarding usefulness and other aspects of "success" for each project. The LMC IAIMS project will accomplish two important goals: the implementation of IAIMS ideas within LMC, and the testing of a new approach for evolving information systems in a complex community environment.